A certified coding specialist, also referred to as a medical coder or health information technician, is a medical professional responsible for overseeing patient records and ensuring bills are paid properly and on time.
CCSs are skilled in classifying medical data from patient records, generally in a hospital setting. These coding practitioners:
- Review patients’ records and assign numeric codes for each diagnosis and procedure
- Possess expertise in the ICD-10-CM and CPT coding systems
- Are knowledgeable about medical terminology, disease processes, and pharmacology.
Different facilities and institutions make use of a CCSs’ skills:
- Hospitals and medical providers take the coded data created by CCSs to insurance companies—or to the government in the case of Medicare and Medicaid recipients—for reimbursement of expenses
- Researchers and public health officials also use this data to monitor patterns and explore new interventions
Coding accuracy is highly important to healthcare organizations, and has an impact on revenues and describing health outcomes. In fact, certification has become an implicit industry standard. Accordingly, the CCS credential demonstrates a practitioner’s tested data quality and integrity skills, and mastery of coding proficiency. Professionals experienced in coding inpatient and outpatient records should consider obtaining this certification.
CCS – Eligibility FAQ Document
Candidates must meet one of the following eligibility requirements:
- By Credential: RHIA®, RHIT®, or CCS-P® OR
- By Education: The following courses MUST be completed; anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic/procedural and CPT coding; OR
- By Experience: Minimum of two (2) years of related coding experience directly applying codes; OR
- By Credential with Experience: CCA® plus one (1) year of coding experience directly applying codes; OR
- Other Coding credential from other certifying organization plus one (1) year coding experience directly applying codes.
Certified Coding Specialist (CCS) Examination Content Outline